NPLQ First Aid and Casualty Care 2 — Questions and Answers
Question 1: What is the primary goal of the 'primary survey' in first aid assessment?
- To diagnose the underlying medical condition
- To identify and treat immediately life-threatening conditions in a structured sequence (Correct answer)
- To document all injuries for an incident report
- To assess the pool environment for hazards
Correct answer: To identify and treat immediately life-threatening conditions in a structured sequence
The primary survey (DRABC or ABCDE) identifies life-threatening problems — particularly airway obstruction, absent breathing, and severe bleeding — that require immediate intervention.
The primary survey uses a systematic approach (often DRABC: Danger, Response, Airway, Breathing, Circulation) to rapidly identify the most critical threats to life. It prioritises in order: ensuring scene safety, assessing responsiveness, opening/maintaining the airway, confirming adequate breathing, and checking for severe circulation issues including catastrophic bleeding.
Question 2: A bather is found unconscious at the poolside with a suspected head injury. How should the airway be opened?
- Jaw thrust only, avoiding neck extension (Correct answer)
- Head-tilt chin-lift with full neck extension
- No airway opening — wait for paramedics
- Log roll the casualty prone before airway assessment
Correct answer: Jaw thrust only, avoiding neck extension
For casualties with suspected spinal or head injury, the jaw thrust technique opens the airway without extending the cervical spine, reducing the risk of cord damage.
The jaw thrust is performed by placing two or three fingers under the angle of the jaw on each side and lifting the mandible forward, displacing the tongue away from the posterior pharynx without extending the neck. If the jaw thrust alone does not open the airway adequately, a modified head-tilt may be added as a last resort. For NPLQ purposes, the jaw thrust is the preferred technique whenever cervical spine injury is suspected.
Question 3: What is the correct management for a conscious adult bather with severe external bleeding from a limb?
- Apply a tourniquet immediately above the wound
- Apply direct pressure with a clean cloth and maintain it (Correct answer)
- Elevate the limb and leave unattended while calling EMS
- Irrigate the wound with pool water
Correct answer: Apply direct pressure with a clean cloth and maintain it
Direct pressure applied firmly and continuously is the primary first aid treatment for severe external bleeding. It promotes clotting and reduces blood loss.
Applying direct, sustained pressure over the wound — ideally with a sterile or clean absorbent pad — is the most effective first aid for external haemorrhage. The rescuer should press firmly and not remove the dressing to check; if blood soaks through, additional material is placed on top. Pool water is not sterile and should never be used to irrigate open wounds.
Question 4: Which of the following is a sign of shock in a pool casualty?
- Flushed warm skin with a strong bounding pulse
- Pale, cold, clammy skin with a rapid weak pulse (Correct answer)
- Fully alert and oriented with normal blood pressure
- Slow deep breathing with normal skin colour
Correct answer: Pale, cold, clammy skin with a rapid weak pulse
Shock (circulatory failure) presents with pale, cold, clammy skin; rapid, weak pulse; rapid shallow breathing; confusion; and nausea as blood is redirected from the periphery to vital organs.
Hypovolaemic or neurogenic shock results in sympathetic activation: peripheral vasoconstriction (pale, cold skin), tachycardia (rapid pulse), and reduced organ perfusion. First aid management includes: treating the cause, laying the casualty flat and raising the legs if appropriate, keeping warm, and calling EMS urgently.
Question 5: What is the recovery position and why is it used?
- Lying flat on the back to facilitate CPR if needed
- On the side with the airway angled down, to maintain airway patency and allow fluid drainage (Correct answer)
- Sitting upright to assist breathing
- Face down to reduce aspiration risk
Correct answer: On the side with the airway angled down, to maintain airway patency and allow fluid drainage
The recovery position places an unconscious but breathing casualty on their side so the airway remains open and any vomit or secretions drain away rather than being inhaled.
The recovery position is used for unconscious casualties who are breathing adequately. The casualty is placed on their side with the top leg bent forward to prevent rolling, the head tilted back to maintain airway patency, and the mouth facing downward so fluids drain out. If spinal injury is suspected, log-roll technique should be used to move the casualty.
Question 6: A child is rescued from the pool and shows signs of near-drowning. They are conscious and coughing. What should you do?
- Reassure them and let them rest in the changing room
- Give oxygen if available, keep warm, and call for EMS due to secondary drowning risk (Correct answer)
- Return them to the water for gradual acclimatisation
- Give them a warm drink immediately to help recovery
Correct answer: Give oxygen if available, keep warm, and call for EMS due to secondary drowning risk
Any near-drowning casualty who has inhaled water, even if conscious, needs medical evaluation due to secondary/delayed drowning risk. Supplemental oxygen, warmth, and emergency services are priorities.
Near-drowning casualties may aspirate water causing surfactant washout, alveolar collapse, and hypoxia that can develop or worsen over the following 4–24 hours. Even if the child appears conscious and well, persistent coughing is a warning sign. Oxygen supplementation (if trained and equipped), maintaining warmth, continuous monitoring, and immediate EMS activation are mandatory. The child must not be left alone or given food/fluids.
NPLQ First Aid and Casualty Care 2
What is the primary goal of the 'primary survey' in first aid assessment?